1. Field of the Invention
The present invention relates to endoscopic surgical instruments, and more particularly to endoscopic surgical instruments for aspirating and irrigating a surgical site having a plurality of interchangeable tool tip members for performing surgical procedures.
2. Discussion of the Prior Art
Surgical devices for providing irrigation fluid and suction to a surgical site to irrigate and evacuate the tissue in the area on which the surgical procedure is being performed are well known in the art. Several of these devices provide a handle member having switching means for turning on and off the flow of the fluid stream and the suction means, and typically connect the suction source and the fluid source to an elongated flexible tubular member which is positioned adjacent the surgical site. In many instances, the tube or catheter is comprised of a complex series of passages which provide a separate channel for the irrigation fluid and a separate channel for the suction means. Several devices provide a pump source to provide the fluid under pressure; however, other devices provide a source of irrigation fluid which is operable under head pressure to gently wash the tissue. The prior art devices typically provide a large tube or catheter which enclose the several channels to deliver the fluid and provide the suction during oral surgery, or invasive surgery which allows for the positioning of the cumbersome tubing.
Several of the prior art devices provide numerous features including electrocautery, laser dissection, and viewing capabilities, all through a single tool member disposed at the operative distal end of the device. Typically, the handle grip includes on/off switches in the form of trumpet valves which allow the surgeon to selectively choose the suction or irrigation feature. Many devices provide a pistol type hand grip which allows the surgeon to operate the device with the thumb-actuated valves. Other devices provide tubular connections such as Luer-type connectors to couple the irrigation source or the suction source to the catheter or tube.
With the recent developments in endoscopic and laparoscopic surgical procedures, it is necessary to provide a device in which many of the functions provided by the more complex and cumbersome prior art devices are included in a streamlined construction in which many of the features are provided in a single unit. In laparoscopic and endoscopic surgical procedures, a small incision or puncture is made in the patient's body to provide access for a tube or cannula device. The cannula is inserted into the patient's body through the provision of a trocar assembly which further includes an obturator for penetrating the body wall. After the obturator is removed, the cannula remains in place to maintain access to the surgical site. Once the cannula is in place, the surgical instrument may be inserted through the cannula to perform the procedure, while the surgical area is viewed through an endoscope or a miniature camera inserted through secondary cannulas to display the procedure on a video monitor.
The prior art devices are subject to several disadvantages when considered for use in laparoscopic or endoscopic surgical procedures. The primary focus behind such surgical procedures is that the surgery is minimally invasive to the patient's body, consequently reducing damage to surrounding tissue and organs and reducing the scarring resulting from the operation, which, as a result, greatly reduces recovery time for the patient. The prior art devices, which typically provide a plurality of channels in the tube or catheter portion to transport the suction and irrigation means to the surgical site, are generally provided for invasive type surgery which allows the larger diameter catheters to be manually positioned adjacent the surgical objective through large incisions.
A further limitation to which the prior art devices are subjected involves positioning of the device during the surgical procedure. Many of these devices are provided with a pistol-type grip which requires a particular orientation of the device in relation to the surgeon's position during the procedure. Should it become necessary for the device to be relocated during the surgical procedure, it is often times uncomfortable to the surgeon to position the device at an angle that does not facilitate operation of the valve members to turn the various features on and off. As a result, the effectiveness of the device is limited, and in many times requires a surgical assistant to operate the device for the surgeon.
Typical suction and irrigation devices having a hand grip in the shape of a pistol are disclosed in U.S. Pat. No. 4,149,315 to Page, Jr. et at. and U.S. Pat. No. 4,776,840 to Freitas et al. Page, Jr. et at. provides a dental suction/irrigation device which includes an elongated tube member which transports the suction means and the irrigation means to the tissue site. The elongated tubular member comprises a pair of concentric tubes where the inner tube provides the irrigation fluid and the outer tube is provided for the suction. A pair of trumpet valves are provided to actuate the irrigation source and the aspiration source. Freitas et al. discloses a similar device but includes a complex internal manual pump to provide the irrigation fluid. A second flexible tube is provided for a vacuum source to evacuate fluid and gases from the surgical site.
U.S. Pat. No. 4,744,360 Bath provides a surgical device for removing cataract lenses which includes an optical fiber for laser surgery which is surrounded by an irrigation sleeve and a separate aspirator sleeve which provides fluid for irrigation and suction for evacuation, respectively, of the surgical site.
A Cabot Medical Corporation brochure (copyright 1990) discloses a suction/irrigation probe which includes a hydrodissection insert which comprises a rod which passes through the tube of the suction/irrigation probe to adjust the flow of the irrigation fluid.
Other known devices include U.S. Pat. No. 4,921,476 and U.S. Pat. No. 4,493,694 to Wuchinich, and U.S. Pat. No. 3,527,203 to Gravlee, which include a tube having several channels for carrying the irrigation fluid separately from the suction device.
A further disadvantage to the devices known in the prior art lies in the fact that the operative end of the device includes only one, non-changeable tool member, if a tool member is provided at all. Typically, suction and irrigation devices terminate in an open tube member for aspirating or irrigating the surgical site. Those devices which do provide a tool at the operative end generally have a permanent member in position, so that the surgeon must change instruments in the event a different tip is required. Some prior art devices have interchangeable tool members, however each tool is attached to a different tubular member so that the entire tubular member needs to be replaced. This causes difficulty in changing tools due to the maneuvering and hand manipulation required to switch tubular members, and further increases the expense of the instruments.
The novel endoscopic surgical device for suction and irrigation of tissue during a surgical procedure obviates the disadvantages encountered in the prior art and provides a compact instrument which includes many of the features necessary to perform the surgical procedure, and which is dimensioned to fit through a cannula for the performance of endoscopic or laparoscopic surgical procedures. The device of the present invention allows a surgeon to operate the suction and irrigation device with either hand and at any orientation to the surgical site comfortably and without assistance, and further allows the surgeon to expand the surgical procedure through the provision of a plurality of interchangeable tool tip members for quick connection to the surgical device. The tool tips preferably are provided in an indexable case to allow the surgeon to choose the right tool tip for the required surgical procedure.